Percutaneous Endoscopic Lumbar Discectomy (PELD)
Percutaneous endoscopic lumbar discectomy, or PELD, is a surgical procedure used to remove the central portion of an intervertebral disc. It is a minimally invasive surgical procedure and uses a small and thin tube, called a cannula, to access the soft material inside the disc and remove the excessive portion to provide swift pain relief.
Need for Percutaneous Endoscopic Lumbar Discectomy (PELD)
The need for a percutaneous endoscopic lumbar discectomy (PELD) surgery is mostly seen for patients suffering from a herniated disc pressing on the spinal nerves, which is causing severe back and leg pain. The choice for undergoing a minimally invasive or an open (conventional) surgical approach for the discectomy depends mainly on your overall health and fitness level.
Percutaneous Endoscopic Lumbar Discectomy (PELD) procedure
This is a minimally invasive surgical procedure that uses an endoscope to access the herniated disc and perform the required surgery with specialized surgical instruments.
The surgery requires administering general anesthesia to the patient in order to avoid any kind of pain or discomfort during the surgery. A few small (keyhole) incisions are made in the skin directly over the affected disc, if possible. A small, thin and flexible tube (endoscope) is inserted through one of these incisions. This endoscope is attached with a light-source and a small but powerful video camera at one end. This endoscope is guided towards the trouble spot and gives a highly magnified and clear view of the herniated disc and allows for better control and more precision in using the smaller surgical instruments. In addition to the endoscope the surgeon may also use fluoroscopic guidance techniques to further aid in locating and viewing the herniated disc in better detail.
Once the endoscope camera is in place the surgeon will insert a thin wire into the incision till it touches the inflated disc and this wire will be used as a guide for inserting a thicker tube inside the body. This tube is used to pass the various miniaturized surgical instruments that are required to cut a portion of the disc wall to access the internal fluid. This excessive internal inter-vertebral fluid is then removed in order to relieve the pressure from the inflated disc walls.
The decrease in size of the disc results in creating additional space inside the disc for the nerve roots in the spinal cord. This helps relieve the pain being caused by these previously affected nerves and may also restore mobility in the spinal column.
Advantages of Percutaneous Endoscopic Lumbar Discectomy (PELD)
As the percutaneous endoscopic lumbar discectomy procedure is a minimally invasive surgical procedure it carries certain advantages over the conventional open-type surgical discectomy.
These are some of the advantages of a percutaneous endoscopic lumbar discectomy (PELD) procedure:
- High rate of immediate pain relief experienced
- Direct access to the affected (herniated) disc
- The disc-annulus and ligament are not removed
- May also be performed under sparing local anesthesia if required
- Performed as an outpatient procedure with mostly same day release from the hospital
- Shorter rehabilitation due to smaller incisions
- Less pain and faster recovery due to minimally invasive nature
- Less scarring due to smaller (keyhole) incisions
Possible Risks and Complications of Percutaneous Endoscopic Lumbar Discectomy (PELD)
As with any type of major surgery the percutaneous endoscopic lumbar discectomy (PELD) procedure also carries the chances of certain risks and complications from arising, such as:
- Blood clot
- Nerve damage
- Soft tissue damage
- Spinal fluid leakage
- Anesthetic reaction
The orthopedic specialist/surgeon will take every possible precaution in order to avoid these risks from developing during, or after, the PELD surgery.